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BROWN UNIVERSITY HEALTH PHARMACY NO 002
DSH220073 MORTON HOSPITAL
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Covered Entity Details
Entity Name
MORTON HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220073
Entity Address
88 WASHINGTON STREET
TAUNTON, MA 02780
Medicare Provider Number
220073
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
BROWN UNIVERSITY HEALTH PHARMACY NO 002
Pharmacy Address
164 SUMMIT AVE
PROVIDENCE, RI 02906
Pharmacy Comments
Contract Details
Approval Date
2/23/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Taylor, President and VP of Finance
(508) 406-8078
Contract Pharmacy Representative
Brown University Health
Christine Collins, SVP, Pharmacy Periop Chief Pharmacy Officer
(401) 444-4434
Signed By Date
1/15/2025
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